1744-P: Baseline Body Mass Index and Its Change Patterns and All-Cause Mortality in Adults with Type 2 Diabetes—A Real-World Study

Introduction and Objective: We aimed to explore the association of baseline body mass index (BMI) and its change trajectory patterns with all-cause mortality among patients with type 2 diabetes. Methods: This study included 3703 patients (57.9% men) aged 18-80 years with at least three BMI measurements within 4 years since their first inpatient diagnosis of type 2 diabetes in the PREMIRE cohort. BMI was categorized into 5 groups according to the WHO criteria (<18.5 kg/m2, 18.5-23.9 kg/m2, 24.0-27.9 kg/m2, 28.0-39.9 kg/m2, ≥40kg/m2). Latent class trajectory models were used to identify BMI change patterns. Results: The median baseline BMI was 24.7 (interquartile range 22.5-27.2) kg/m2. Compared with BMI within 18.5-23.9 kg/m2, lowest risks were observed in patients with overweight and mild obesity for total mortality (BMI 24.0-27.9 kg/m2: hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.63-0.86; BMI within 28.0-39.9 kg/m2: HR 0.64, 95%CI 0.52-0.80). BMI ≥40 kg/m2 was not associated with higher mortality (HR 0.31, 95%CI 0.04-2.24). BMI <18.5 kg/m2 was associated with a higher risk of mortality (HR 1.54, 95%CI 1.08-2.18). After a median follow-up of 5.2 years, 787 patients died. Four distinct trajectories of BMI were identified. Compared with stable class, multivariable-adjusted hazard ratios of all-cause mortality were 1.88 (95% confidence interval [CI] 1.21-2.90) for inverse U-shape class, 0.85 (95%CI 0.47-1.54) for U-shape class, and 0.47 (95%CI 0.24-0.95) for L-shape class, respectively. Subgroup analysis showed that the negative effect of inverse U-shape trajectory was more pronounced in patients aged ≥65 years, while the beneficial effect of L-shape trajectory was more predominant in patients aged <65 years. Conclusion: In patients with type 2 diabetes, low body weight as well as BMI trajectories of inverse U-shape were associated with an increased risk of all-cause mortality. T. Hu: None. Y. Xu: None. X. Li: None. X. Ma: None. Y. Bao: None.